Special Event Application

  • Special Event Application

    For Single Events

  • Click here for Insurance Terms & Definitions.

  • APPLICANT INFORMATION

     

  • What coverages do you require?*
  •  -

  • UNDERWRITING QUALIFICATION QUESTIONS

  • Do any events include any of the following: Stunts, Pyrotechnics, Aircrafts, Car Races, Precision Driving, Mechanical Amusement Devices, Film Production, or other Hazardous Activities?*
  • If the above activities are managed by a vendor, exhibitor or sub-contractor, do they have their own liability insurance in place listing you as Additional Insured?*
  • Will any of the events occur in a bar or nightclub?*
  • Are those events occurring in a bar or nightclub open to the public?*
  • Will the event take place within the United States?*
  • Will the applicant sub-contract any other companies for the insured event(s)?*
  • If yes, will these sub-contractors provide a certificate of insurance, naming you as Additional Insured?*
  • Will there be security at the insured event(s)?*
  • If provided by anyone other than the venue, does the security company carry its own insurance naming you as Additional Insured?*
  • Have you had any liability or property losses in the past 5 years?*
  • Will alcohol be served at the event?*
  • Will there be any temporary structures built/installed for the event?*
  • If a subcontractor is responsible, will they name your company as an Additional Insured on their insurance policy?

  • EVENT DETAILS

  • Select the type of event:*

  • Event Start Date*
     - -
  • Event End Date*
     - -
  • Event will be held:*

  • General Liability

    General Liability covers payments the insured will become legally obligated to pay as a result of Bodily Injury or Property Damage arising out of an occurrence during live events, performances, etc. Applies to third parties, excluding your own cast and crew, location. Injury to your own cast and crew can be covered under workers compensation, if selected. If you would like a quote with workers compensation a separate application is be required.
  • Do you require a waiver of subrogation?*

  • Liquor Liability

  • Will alcohol be served by a Licensed bartender?*
  • Does the Applicant have a valid Liquor License?*
  • Will there be an open bar?*
  • Is BYOB (bring your own bottle) allowed?*
  • Will alcohol be served by the drink?*
  • Have you ever been assessed a fine or violation of law concerning the sale, serving or providing of alcohol?*
  • Has the applicant had any occurrences that have arisen out of the sale, serving, or providing of any alcoholic beverage?*
  • Are servers, bartenders and parking valets required to participate in alcohol awareness programs?*
  • Is there a designated driver program or escort service provided for those unable to drive?*
  • Is there a limit placed on the quantity of alcoholic beverages purchased at one time?*

  • Rented Equipment

  • Will the property be stored overnight?*
  • Will the Insured be responsible for transporting the property?*
  • Is the company transporting the property naming the Insured as Additional Insured on their Insurance policy?*
  • Will the property stay in the possession of the Insured at all times prior to returning to rental company?*

  • Auto Coverage

  • Do you require Hired/Non-Owned Auto Liability?*
  • Are you required by contract to acquire Hired/Non-Owned Auto but are not being loaned, rented or leased any vehicles?*
  • Are all drivers at least 25 years of age?*
  • Do all drivers have a valid United States drivers license?*
  • Do any of the hired vehicles seat more than 12 people?*
  • Will any bus or van be hired for the purpose of transporting people?*

  • Participants Medical

    Not available for all types of events.

  • Music/Concert Events

  • Music Genres:*

  • Is seating assigned?*

  • Sporting Event

  • Are participants required to sign a waiver?*
  • Are participants required to provide proof of health insurance?*
  • Are safeguards in place to protect spectators?*

  • Retreat/Overnight Event

  • Is this an overnight event?*

  • Workers Compensation

    Covers medical injury to your hired cast or crew. This may include W2 employees, 1099 freelancers & volunteers. Available in most states.
  • Worker’s Comp limit of $1,000,000*
  • Waiver of Subrogation
  • Rows
  • Rows

  • Additional Information, Comments

  • Would you like to receive our quarterly newsletter?*

  • NY License # BR-1001302          

    CA License   # 0I36156 - dba in CA as New York Film Emporium Insurance Services

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